Medical Oncologist
CION Cancer Clinics
Follow-up after a gastrectomy: what the schedule looks like | CION Cancer Clinics
After a gastrectomy for cancer, most people are seen every few months for the first two years, then less often for several more years. Blood tests for vitamin B12, iron and bone health continue for life. This page explains what happens at each visit, which tests are used and why, and what to do if visits have been missed or the centre is far from home. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How often are you seen after a gastrectomy?
- What happens at each stage of follow-up?
- What is actually checked at each visit?
- Which tests are used in follow-up, and what each one is for
- Four things families tell us about follow-up, and what is true
- Words you will see on the follow-up plan, in plain language
- What this page cannot tell you, and what to do about missed visits
- Common questions about follow-up after a gastrectomy
The short answer
How often are you seen after a gastrectomy?
After a gastrectomy for cancer, most people are seen every few months for the first two years, then less often, usually until about the five-year mark. Blood tests for vitamin B12, iron and bone health carry on for life, even after the cancer check-ups stop.
Why there are two schedules running at once
One schedule is about the cancer. It watches for any sign of it coming back, with an examination, questions about symptoms, and scans when your team thinks they are needed. The other is about living without a stomach. Vitamins the stomach used to help absorb run low slowly, so blood tests continue long after the cancer visits have become rare. Families often forget the second.
Why your own schedule may look different
The pattern above is typical, not fixed. Your surgeon sets the gaps based on the stage found at surgery, whether chemotherapy is planned, how you are recovering and how far you live from the centre.
This page describes the usual shape of follow-up. It cannot tell you what your own team will choose, and it is not a reason to skip a visit already booked.Visit by visit
What happens at each stage of follow-up?
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The first visit after going home
Usually soon after discharge. The surgeon checks the wound, asks how eating is going, looks at your weight and goes through the pathology report with you. Any chemotherapy is confirmed at this visit.
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The first year
Reviews every few months. Weight, eating problems, dumping and loose motions are the main topics. Blood tests start to track B12 and iron. A scan may be done if symptoms suggest it or if one is planned.
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The second year
The same pattern continues. Most people are eating well by now, so visits become shorter. The team still watches closely, because this is when a return of the cancer is most likely to show.
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The middle years
Visits stretch out to twice a year, then yearly. Blood tests continue. Bone density may be checked. Towards the end, many teams move the cancer side of follow-up to your local doctor.
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The long term
Cancer check-ups usually stop or become occasional. The vitamin checks and B12 injections do not stop. Make sure any local doctor knows you have had a gastrectomy.
Not sure whether this applies to you?
Ask an oncologistAt a typical review
What is actually checked at each visit?
- Your weight, and how it compares with the last visit
- How eating is going, and any food that sticks or comes back
- Dumping, loose motions, bile coming up and bloating
- Tiredness, breathlessness, numbness in the feet
- An examination of the abdomen and the scar
- Blood counts, B12, iron stores, calcium and vitamin D
- A scan, if one is due or if symptoms call for it
- Any new lump, pain, or change the family has noticed
The tests
Which tests are used in follow-up, and what each one is for
Not every visit includes every test. Your team chooses by stage, symptoms and time since surgery.
Blood tests
The workhorse of follow-up. A full blood count picks up a low haemoglobin. B12, ferritin (iron stores), calcium and vitamin D show whether the vitamin side is being kept up. Some teams also check a tumour marker, though on its own it proves nothing.
CT scan
Looks at the abdomen and chest for any sign of the cancer coming back. Some teams scan on a fixed pattern; others scan only when something has changed. Both are accepted, so ask which yours follows.
A clear scan is reassuring for that visit, not a final answer.Endoscopy
A thin camera passed down the throat to look at the join and, after a partial gastrectomy, the remaining stomach. It is used when food is sticking, when there is bleeding, or on a planned basis.
Bone density (DEXA)
A quick, low-dose scan of the hip and spine. Calcium is absorbed less well without a stomach, so bones can thin over the years. It is repeated if it shows a problem.
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Commonly believed
Four things families tell us about follow-up, and what is true
"He is eating well, so we do not need the check-up."
Eating well is good news about the operation, not about the cancer. A return of the cancer often causes no symptoms at first, and low B12 causes none for a long time. The visit is there to find what you cannot feel.
"A scan every visit would be safer."
More scans do not automatically mean earlier detection. Each one carries a small dose of radiation and can find harmless things that then need more tests. If you want to understand your team's pattern, ask.
"The local doctor can do all of this."
A local doctor can do the blood tests and B12 injections, which saves travel. The cancer review in the early years needs the surgical team, because they know what was found. Sharing the work between the two is the usual answer.
"We missed two visits, so it is too late to go back."
It is never too late. Missed visits are common, especially from the districts, and no one will be scolded. Call, say what was missed, and the team will decide what needs catching up.
On your follow-up letter
Words you will see on the follow-up plan, in plain language
- Surveillance
- Watching for the cancer coming back through planned visits, tests and scans. It does not mean the team expects it to return.
- Recurrence
- The cancer coming back, near where it was or elsewhere in the body. This is what the cancer side of follow-up looks for.
- Adjuvant chemotherapy
- Chemotherapy given after surgery to lower the chance of the cancer returning. It runs alongside the surgical follow-up.
- Tumour marker
- A protein in the blood, such as CEA, that can rise if cancer is active. It prompts more tests; it is not a diagnosis.
- Anastomotic stricture
- A narrowing at the join the surgeon made. Food sticks, and it is usually stretched with an endoscope rather than another operation.
Being straight with you
What this page cannot tell you, and what to do about missed visits
This page cannot tell you your own schedule, or what a normal result means for the years ahead. Both come from your team, who know the stage found at surgery and how you have recovered.
If you live far from the centre
Tell the team at the first visit. Blood tests and B12 injections can often be done near home and the results shared, so the journey is made only for visits that need the surgeon. Ask for a written plan a local doctor can follow.
If visits have been missed
Call and say so. The team will tell you which tests need catching up. Cost, travel and a feeling that things are fine are the usual reasons, and none will surprise anyone. What matters is picking the schedule up again.
If a new symptom appears between visits
Do not wait for the next date. Food sticking, vomiting, black stools, new pain, a new lump, or weight falling after it had settled all need a call the same week.
If the centre where you were operated on is too far, call the helpline. We will help you find a clinic that can pick up the plan.Questions we are asked
Common questions about follow-up after a gastrectomy
How many years does follow-up go on for?
The cancer check-ups usually continue for several years, becoming less frequent over time. The vitamin side does not end. B12 injections and blood tests for iron and bone health continue for life, because the stomach's role in absorbing them does not come back. Your team will say when the cancer visits can stop.
Will there be a scan at every visit?
Usually not. Some teams scan on a fixed pattern in the early years, others only when symptoms or blood tests suggest a change. Both are accepted. A visit without a scan is not a visit where nothing was checked; the examination, weight and blood tests do most of the work.
Can the blood tests be done near home?
Often yes. Ask your team for the list of tests and the gaps between them, have them done at a local laboratory, and send the results before the visit. The same applies to B12 injections. After the first year, fewer visits need the surgeon in person than families expect.
What if he is also having chemotherapy?
Then the medical oncology team sees him far more often in the early months, and the surgical reviews fit around those visits rather than being added on top. Ask the two teams to share one plan so you are not travelling twice in the same week.
Does a normal check-up mean the cancer is gone?
It means nothing was found at that visit, which is good news for that visit. Neither a scan nor a blood test can see very small deposits, so the team keeps watching for several years. No single visit can tell you what the years ahead hold.
Who gives the B12 injections after the hospital stops seeing us?
Any doctor or nurse can give them, including at a local clinic. What matters is that the doctor knows why they are needed, so keep the discharge letter and show it to any new doctor. Your team sets the gap between injections; do not change it without asking.
What should we bring to each visit?
Recent weights, any local blood results, a note of foods that cause trouble, the list of medicines, and the discharge summary if it is a new doctor. Bring the family member who does the cooking, and write your questions down beforehand.
Is follow-up covered by Aarogyasri or insurance?
Visits, blood tests and scans linked to an approved cancer treatment are often covered, and Aarogyasri, CGHS, ECHS and EHS are accepted at CION. Cover for long-term vitamin tests and B12 injections varies by scheme. Call the helpline with your card details and we will check your own cover.
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Dr. C. Raghavendra Reddy
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- American Cancer Society — Stomach cancer
- Cancer Research UK — Stomach cancer
- Macmillan Cancer Support — Stomach cancer
- NHS — Stomach cancer
- National Cancer Institute — Stomach (gastric) cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Life One Year After GastrectomyWhat eating, weight and energy usually look like at a yearVitamin B12 After Gastrectomy: Lifelong InjectionsThe one part of follow-up that never endsIron and Calcium Deficiency After GastrectomyWhy the blood tests keep looking at theseRecovery Timeline After GastrectomyThe weeks before the first follow-up visitThe Pathology Report After SurgeryThe report that sets your follow-up plan
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Not sure where your follow-up stands?
Tell us what was done and when you were last seen. A surgical oncologist will look at it with you and say what needs catching up. One helpline serves every CION centre.